Evaluation of a school oral health education programme in Tanzania : an ecological perspective

Abstract

This study evaluated the primary school oral health education programme in Tanzania, which is being implemented by teachers. The oral health education needs of pupils, environmental support for the programme, the preparedness of teachers for the oral health education task, the delivery process of conventional oral health education, and the impact among pupils were assessed in terms of the CIPP (context, input, process, product) evaluation model. The study was carried out in a selected district. The pupils and their teachers were studied by interviews, questionnaires and clinical observations, while the environments and the educational process were observed. Children not yet given oral health education at school (reference group, n=200) were found to have poor oral health knowledge, attitudes, practices and skills. The children's environments appeared less supportive of oral health education messages. The teachers who conducted oral health education generally had no training in it and seemed to have inadequate knowledge, skills and motivation for this task. The oral health education sessions were poor in content and methods. The impact on pupils attending these sessions (conventional session group, n=200) was poor. On the basis of these findings, a modified oral health education manual was produced. Using the manual as a framework, teacher training was provided in workshops to all teachers responsible for school oral health education in the study district, while in an adjacent district a sample of teachers were issued the teaching manual only. These measures were carried out with the dental personnel and school administrators of the study area. The teachers trained in workshops, but not those given the manual only, were able to improve both the content and methods of their oral health education sessions, and the impact on pupils who participated in these sessions (modified session group, n=200) improved.